Abstract Introduction Breastfeeding is widely recommended. Updated data are needed to assess its prevalence and the effectiveness of interventions. Breastfeeding practices in Italy need to be promoted and monitored with updated and standard data The objective of this study is to provide estimates of the prevalence of breastfeeding and exclusively breastfeeding and to identify factors that may be modified to improve them. Materials and methods Two population-based follow-up surveys were conducted to evaluate the quality of maternal care in 25 Local Health Units in Italy during 2008-2011. Women were interviewed soon after giving birth and after 3, 6 and 12 months. Breastfeeding prevalences were estimated. A logistic regression model was used to investigate factors associated with exclusive breastfeeding at 3 months. Results Breastfeeding and exclusively breastfeeding prevalences were 91.6% and 57.2% at discharge, 71.6% and 48.6% at 3 months, 57.7% and 5.5% at 6 months. At 12 months, 32.5% were still breastfeeding. Women who are more likely to exclusively breastfeed at 3 months are multiparous, more educated, resident in the north/center, have attended antenatal classes and groups of breastfeeding support, have practiced the skin-to-skin contact in hospital and have initiated breastfeeding early. Conclusion In Italy many mothers do not comply with breastfeeding recommendations. The promotion and support of breastfeeding is still necessary in Italy and still needs to be monitored with representative data. Actions should aim at empowering women, reducing social inequalities and improving practices in hospitals and maternal care services which encourage breastfeeding
